Percutaneous thoracic aortic aneurysm repair through transcaval aortic access

Catheter Cardiovasc Interv. 2017 Nov 1;90(5):806-808. doi: 10.1002/ccd.27130. Epub 2017 May 22.

Abstract

Transcaval aortic access has been used for deployment of transcatheter aortic valves in patients in whom conventional arterial approaches are not feasible. This access can be vital in other situation when large bore access is needed. We described a case of 65-year-old man who had large thoracic descending aortic aneurysm with diffuse bilateral iliac disease precluding the arterial access required for the procedure. The patient underwent successful transcaval access with placement of 22-Fr balloon expandable sheath followed with successful deployments of 32 mm × 32 mm × 150 mm Valiant stent graft (Medtronic, Minneapolis, MN). The aorto-vena cava tract was closed successfully using 12 × 10 PDA occluder device with no residual flow at the end of the case, which was confirmed on repeated CT next day.

Keywords: TEVAR; thoracic aortic aneurysm; transcaval.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Angioplasty, Balloon / instrumentation
  • Angioplasty, Balloon / methods*
  • Aortic Aneurysm, Thoracic / diagnostic imaging
  • Aortic Aneurysm, Thoracic / surgery*
  • Aortography / methods
  • Blood Vessel Prosthesis
  • Blood Vessel Prosthesis Implantation / instrumentation
  • Blood Vessel Prosthesis Implantation / methods*
  • Catheterization, Central Venous / methods*
  • Computed Tomography Angiography
  • Humans
  • Male
  • Phlebography / methods
  • Prosthesis Design
  • Punctures
  • Stents
  • Treatment Outcome
  • Vena Cava, Inferior* / diagnostic imaging